心脏介入导管室手卫生方式的优化选择  

Optimal selection of hand hygiene methods in cardiac catheterization room

作　　者：张昆[1] 王春怡[1] 刘倩[1] 谢晨[1] 

机构地区：[1]阜外心血管病医院导管室,北京100037

出　　处：《中华医院感染学杂志》2014年第14期3586-3588,共3页Chinese Journal of Nosocomiology

基　　金：中华医院感染控制研究基金资助项目(ZHYY12-015)

摘　　要：目的从多种手卫生方式中优化选择一种切实可行的手卫生方式,为医务人员提供安全、舒适、快捷的手卫生方法。方法于2013年3-4月随机选择医院导管室12名护士使用5种不同种类消毒液和洗手方法,每人每天使用1种洗手方法1次,监测2d;方法1：使用外科手消毒液10ml揉搓1min,消毒擦手纸巾擦干;方法2：使用免洗外科手消毒液10ml揉搓双手及手臂至干;方法3：使用免洗手消毒液10ml喷涂双手及手臂揉搓至干;方法4：使用清水湿润双手及手臂,润肤皂液10ml按六步洗手法揉搓且每步不少于15s后清水冲洗,消毒擦手纸巾擦干;方法5：使用免洗手消毒凝胶10ml揉搓双手及手臂至干;分别取手卫生前、后双手及手臂涂擦采样进行细菌培养,并以问卷方式统计手卫生方式接受程度。结果 5种洗手方法消毒后手部细菌数均明显减少,方法1-5的阳性检出率分别为4.2%、0、0、37.5%、20.8%,与洗手前细菌数比较差异有统计学意义（P〈0.05）;方法2、3消毒后未检出细菌数,效果优于方法1、4、5,差异有统计学意义（P〈0.05）;接受程度方法2、3为100.0%和83.3%,高于方法4的25.0%及方法1、5的16.7%。结论 5种手卫生方法均可用于临床医务人员的手部清洗除菌,但方法2、3的消毒效果和接受程度均高于其他方法,符合安全、舒适、快捷的要求。OBJECTIVE To compare the effects of multiple hand hygiene methods so as to select an appropriate way for medical staff to wash hands.METHODS From Mar 2013to Apr 2014,totally 12nurses who used five disinfectants and hand washing methods in the catheter rooms were enrolled in the study,then one disinfectant was used everyday by each nurse for once,then it was monitored for 2days;the method 1was to make the hands and arms moist with running water,to rub with 10ml of surgical hand disinfectant for one min,and dry with sterilized paper towels;the method 2was to rub the hands and arms dry with the use of 10ml of free hand washing detergent;the method 3was to spray the hands and arms with 10ml of free hand washing detergent and rub to dry them;the method 4was to make the hands and arms moist with running water and then rub with 10ml of moisturizing soap by using six-step hand washing method,with each step for no less than 15seconds,flush with running water and dry them with sterilized paper towels;the method 5was to rub the hands and arms with 10ml of free hand washing disinfection gel till dry.The hand and forearm specimens were sampled for bacterial culture before and after the hand hygiene,and the questionnaire survey was conducted on participants to know the acceptance of each method.RESULTS After the disinfection with the five hand washing methods,the bacterial colony counts on the hands were significantly reduced,the positive rate of detection of the method 1was 4.2%,the method 2 0,the method 3 0,the method 4 37.5%,the method 5 20.8%;as compared with the bacterial colony counts before the hand washing,there was significant difference（P〈0.05）.The bacteria were not detected with the use of the method 2or method 3,which achieved better effect than did the method 1,4,or 5,the difference was significant（P〈0.05）.The acceptance of the method 2and 3were respectively 100.0%and 83.3%,higher than 25.0%of the method 4,16.7%of the method 1,and 16.7%of the method 5.CONCLUSION All of the five hand hygiene methods can

关 键 词：介入导管室 手卫生 选择 

分 类 号：R540.46[医药卫生—心血管疾病]